Justin Fowler, MD

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

M-13069 Issued in ID

Practice address

6165 W Emerald St
Boise, ID 83704-8613

Phone

(208) 302-3900

Fax

(208) 302-3955

NPI assigned

Aug 5, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX, ID, SD, IL, CA, AZ, NV7 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 7

Specialty

Orthopedic Surgery

Education

Rush Medical College of Rush University, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acute Care Surgery Medical Group IncGroup PAC ID 7214006816, 205 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 30)

Interoperability endpoints

• Direct secure messaging: jfowler230824@santaclaravalley.direct-ci.net
• FHIR API: https://api.platform.athenahealth.com/5564/brand/1/csg/1/fhir/r4
• Direct secure messaging: jfowler3400844@direct.trinity-health.org
• FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Acute Care Surgery Medical Group, Inc.

  • Surgery Physician
  • Sacramento, CA
  • NPI 1700069549

  ID, Surgical Critical Care

  Medicare reassignment Care Compare group NPD
• Saint Alphonsus Regional Medical Center Inc

  • Psychologist
  • Boise, ID
  • NPI 1649357716

  Orthopaedic Trauma

  Medicare reassignment NPD
• Acute Care Surgery of South Dakota PC

  • Orthopaedic Surgery Physician
  • Rapid City, SD
  • NPI 1730797184

  IL, Orthopaedic Trauma

  Medicare reassignment NPD
• Acute Care Surgical Affiliates of Texas PA

  • Surgery Physician
  • Corpus Christi, TX
  • NPI 1407322415
  Medicare reassignment NPD
• Banner Churchill Community Hospital

  • Critical Access Hospital
  • Fallon, NV
  • NPI 1265811251
  Medicare reassignment NPD
• Banner Health Physicians West LLC

  • Multi-Specialty Clinic/Center
  • Fallon, NV
  • NPI 1427314186
  Medicare reassignment NPD
• C H Wilkinson Physician Network

  • Family Medicine Physician
  • Irving, TX
  • NPI 1457382947
  Medicare reassignment NPD
• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment NPD
• Sonoran Orthopaedic Trauma Surgeons

  • Orthopaedic Trauma Physician
  • Scottsdale, AZ
  • NPI 1952357022
  Medicare reassignment NPD
• Surgical Affiliates of California

  • Surgery Physician
  • Los Banos, CA
  • NPI 1932440781

  ID

  Medicare reassignment NPD
• Saint Alphonsus Regional Medical Center Inc

  • Psychiatric Hospital Unit
  • Boise, ID
  • NPI 1770687857
  NPD
• Saint Alphonsus Regional Medical Center Inc

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1992736649
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Luke'S Magic Valley Regional Medical Center, LTD.

  • General Acute Care Hospital
  • Twin Falls, ID
  • NPI 1932154705
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1386835585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6165 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048613",
            "telephone_number": "208-302-3900",
            "fax_number": "208-302-3955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5005 N Piedras St",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799205001",
            "country_code": "US",
            "telephone_number": "915-569-2288",
            "fax_number": "915-569-1919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2606 Hospital Blvd Ste E",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "78405",
            "country_code": "US",
            "telephone_number": "361-902-4766",
            "fax_number": "361-902-6571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "613 Elizabeth St Ste 804",
            "address_purpose": "LOCATION",
            "city": "Corpus Christi",
            "state": "TX",
            "postal_code": "784042231",
            "country_code": "US",
            "telephone_number": "361-217-6264",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-539-9582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6565 E Carondelet Dr Ste 235",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857103533",
            "country_code": "US",
            "telephone_number": "520-367-1050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOWLER",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "ID",
            "license": "M-13069",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "ID",
            "license": "M-13069",
            "primary": true
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "NM",
            "license": "MD2014-0304",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "MO",
            "license": "2016027259",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "TX",
            "license": "Q6009",
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO LICENSE",
            "identifier": "2016027259",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1L5640",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCRR",
            "identifier": "P02601779",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390382503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janice Lynette Fountain, PT
• Taylor Kaylyn Fountain, PHARMD
• Carlee Renee Fountaine, MD
• Heather Fountaine, LMSW
• Jaron Fowers, DO
• Tambra Eve Fox Stewart, LCSW
• Anne Jordan Fox, MD
• Ciciley T. Fox, MD
• Cindy Gordon Fox, LMFT
• Donald James Fox, MD

• Surgical Critical Care Physician in Boise, ID
• Providers in Boise, ID by specialty
• Surgical Critical Care Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.